America's historic new health reform legislation:
what you can expect – and when to expect it

On March 23, 2010, President Barack Obama moved the United States closer to universal health care by signing into law the Patient Protection and Affordable Care Act – one of the most significant pieces of legislation in the nation's history.

The reforms will finally remove insurance companies' ability to deny coverage on the basis of pre-existing conditions, ensuring that millions more Americans will have access to high-quality, low-cost insurance, and guaranteeing that Americans won't need to fear the loss of health coverage if they lose their job, switch jobs or become self-employed.

Although some of the health reforms passed into law will not take effect for two or three years, Americans will see many significant provisions of the bill implemented within a year of its passage. View the full implementation timeline.

What can you do to help reduce the number of uninsured – even before the reform measures take effect?

Health reform provisions scheduled to take effect within six months

• The Department of Health and Human Services has developed a tool that will help consumers easily compare health benefits offered by private insurers.
• Americans who have been uninsured for at least six months due to pre-existing conditions will have immediate access to affordable coverage through temporary high-risk pools.
• States will be required to maintain children's health insurance coverage and their Medicaid coverage – and are not allowed to tighten eligibility or make it more difficult for those eligible to enroll. States will have to maintain their CHIP and Medicaid rules until state-based health insurance exchanges are put in place in 2014.
• Dependents will be able to remain covered by their parents' health insurance policies until their 27th birthday.
• Insurance companies will be prohibited from imposing annual and lifetime caps on the amount they pay to cover policy holders' health care needs.
• Insurance companies will be prohibited from denying coverage to children with pre-existing conditions.
• Consumers will have access to new resources that will make it easier for them to appeal coverage determinations or claim denials to their insurance company.
• Insurance companies will no longer able to rescind coverage – or cancel a policy retroactively – unless they can prove fraud by the dropped policy holder.
• A new Web site will provide a full array of resources that will help consumers compare health insurance coverage options and choose coverage that works for them.

2010

• An estimated 4 million seniors who hit the "doughnut hole" – the coverage gap in their Medicare prescription drug benefit – will receive a $250 rebate to help reduce their costs. The gap will be closed by 2020.
• Small employers with fewer than 25 workers – whose average salary is less than $50,000 – will receive a tax credit to help pay for employer-sponsored health benefits, up to 35 percent of the employer's cost of providing coverage for employees.
• The federal government will build on efforts to fight fraud and waste involving the Medicare, Medicaid and CHIP programs by improving and expanding consumer protections. Find out how you can avoid the growing number of health insurance scams.
• The federal government will offer $250 million in grants to states that are already implementing or are planning to implement measures that require insurance companies to justify their premium increases. Companies with excessive rate hikes may be barred from participation in health insurance exchanges.
• New group health plans and plans in the individual market must begin covering preventive health services for individuals and families who enroll on or after September 23. These policy holders can not be charged a copay, co-insurance or deductible for recommended preventive services.
• The law will provide incentives to increase the number of primary care doctors, nurses and physician assistants. Incentives will include scholarships and loan repayments for primary care doctors and nurses working in underserved areas.
• The law will also provide increased payments for rural health care providers to encourage them to continue serving their communities.
• The legislation will create a temporary reinsurance program to help companies that provide early retiree health benefits to offset costs of the coverage.